Prognostic significance of serum aspartic transaminase in diffuse large B-cell lymphoma

Abstract Background Liver function is routinely assessed in clinical practice as liver function tests provide sensitive indicators of hepatocellular injury. However, the prognostic value of enzymes that indicate hepatic injury has never been systematically investigated in lymphoma, including diffuse...

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Main Authors: Ting-Xun Lu, Shuang Wu, Dong-Yan Cai, Ting-Ting Hong, Ying Zhang, Hua-Qiang Gao, Hai-Ying Hua, Xiao-Hong Wu
Format: Article
Language:English
Published: BMC 2019-06-01
Series:BMC Cancer
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12885-019-5758-2
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author Ting-Xun Lu
Shuang Wu
Dong-Yan Cai
Ting-Ting Hong
Ying Zhang
Hua-Qiang Gao
Hai-Ying Hua
Xiao-Hong Wu
author_facet Ting-Xun Lu
Shuang Wu
Dong-Yan Cai
Ting-Ting Hong
Ying Zhang
Hua-Qiang Gao
Hai-Ying Hua
Xiao-Hong Wu
author_sort Ting-Xun Lu
collection DOAJ
description Abstract Background Liver function is routinely assessed in clinical practice as liver function tests provide sensitive indicators of hepatocellular injury. However, the prognostic value of enzymes that indicate hepatic injury has never been systematically investigated in lymphoma, including diffuse large B-cell lymphoma (DLBCL). Methods This study examined the prognostic value of baseline aspartic transaminase (AST) in DLBCL patients. The association between AST and clinical features was analyzed in 179 DLBCL patients treated from 2006 to 2016. All enrolled patients were treated with R-CHOP or R-CHOP-like chemotherapy. Log-rank test, univariable analysis, and subgroup analysis were performed to evaluate the impact of AST on survival. Results AST 33.3 U/L was considered to be the optimal threshold value for predicting prognosis. A higher AST level was associated with advanced stage (P = 0.001), poorer performance status (P = 0.014), elevated lactate dehydrogenase level (P <  0.0001), presence of B symptoms (P = 0.001), high-risk International Prognostic Index (IPI, IPI 3–5) (P = 0.002), non-germinal center B-cell subtypes (P = 0.038), hepatitis B virus surface antigen positivity (P = 0.045) and more extra nodal involvement (ENI, ENI ≥ 2) (P = 0.027). Patients with a higher AST level had a shorter overall survival (OS) (2-year OS rate, 53.6% vs. 83.6%, P <  0.001). Subgroup analysis indicated that higher AST levels have poorer prognostic values in patients without B symptoms and LDH positive groups. Conclusion A pretreatment AST level is associated with OS in DLBCL patients treated with R-CHOP or similar chemotherapy regimens. A high pretreatment AST level might be a reliable prognostic factor for predicting a dismal outcome in DLBCL patients. Serum AST levels may be investigated for use as an easily determinable, inexpensive biomarker for risk assessment in patients with DLBCL.
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spelling doaj.art-e929e23123794843a2d59324325193b02022-12-22T00:02:31ZengBMCBMC Cancer1471-24072019-06-011911910.1186/s12885-019-5758-2Prognostic significance of serum aspartic transaminase in diffuse large B-cell lymphomaTing-Xun Lu0Shuang Wu1Dong-Yan Cai2Ting-Ting Hong3Ying Zhang4Hua-Qiang Gao5Hai-Ying Hua6Xiao-Hong Wu7Department of Oncology, Affiliated Hospital of Jiangnan UniversityDepartment of Hematology, Affiliated Hospital of Jiangnan UniversityDepartment of Oncology, Affiliated Hospital of Jiangnan UniversityDepartment of Oncology, Affiliated Hospital of Jiangnan UniversityDepartment of Oncology, Affiliated Hospital of Jiangnan UniversityDepartment of Hematology, Affiliated Hospital of Jiangnan UniversityDepartment of Hematology, Affiliated Hospital of Jiangnan UniversityDepartment of Oncology, Affiliated Hospital of Jiangnan UniversityAbstract Background Liver function is routinely assessed in clinical practice as liver function tests provide sensitive indicators of hepatocellular injury. However, the prognostic value of enzymes that indicate hepatic injury has never been systematically investigated in lymphoma, including diffuse large B-cell lymphoma (DLBCL). Methods This study examined the prognostic value of baseline aspartic transaminase (AST) in DLBCL patients. The association between AST and clinical features was analyzed in 179 DLBCL patients treated from 2006 to 2016. All enrolled patients were treated with R-CHOP or R-CHOP-like chemotherapy. Log-rank test, univariable analysis, and subgroup analysis were performed to evaluate the impact of AST on survival. Results AST 33.3 U/L was considered to be the optimal threshold value for predicting prognosis. A higher AST level was associated with advanced stage (P = 0.001), poorer performance status (P = 0.014), elevated lactate dehydrogenase level (P <  0.0001), presence of B symptoms (P = 0.001), high-risk International Prognostic Index (IPI, IPI 3–5) (P = 0.002), non-germinal center B-cell subtypes (P = 0.038), hepatitis B virus surface antigen positivity (P = 0.045) and more extra nodal involvement (ENI, ENI ≥ 2) (P = 0.027). Patients with a higher AST level had a shorter overall survival (OS) (2-year OS rate, 53.6% vs. 83.6%, P <  0.001). Subgroup analysis indicated that higher AST levels have poorer prognostic values in patients without B symptoms and LDH positive groups. Conclusion A pretreatment AST level is associated with OS in DLBCL patients treated with R-CHOP or similar chemotherapy regimens. A high pretreatment AST level might be a reliable prognostic factor for predicting a dismal outcome in DLBCL patients. Serum AST levels may be investigated for use as an easily determinable, inexpensive biomarker for risk assessment in patients with DLBCL.http://link.springer.com/article/10.1186/s12885-019-5758-2Non-Hodgkin lymphomaDiffuse large B-cell lymphomaAspartic transaminasePrognosisSurvival
spellingShingle Ting-Xun Lu
Shuang Wu
Dong-Yan Cai
Ting-Ting Hong
Ying Zhang
Hua-Qiang Gao
Hai-Ying Hua
Xiao-Hong Wu
Prognostic significance of serum aspartic transaminase in diffuse large B-cell lymphoma
BMC Cancer
Non-Hodgkin lymphoma
Diffuse large B-cell lymphoma
Aspartic transaminase
Prognosis
Survival
title Prognostic significance of serum aspartic transaminase in diffuse large B-cell lymphoma
title_full Prognostic significance of serum aspartic transaminase in diffuse large B-cell lymphoma
title_fullStr Prognostic significance of serum aspartic transaminase in diffuse large B-cell lymphoma
title_full_unstemmed Prognostic significance of serum aspartic transaminase in diffuse large B-cell lymphoma
title_short Prognostic significance of serum aspartic transaminase in diffuse large B-cell lymphoma
title_sort prognostic significance of serum aspartic transaminase in diffuse large b cell lymphoma
topic Non-Hodgkin lymphoma
Diffuse large B-cell lymphoma
Aspartic transaminase
Prognosis
Survival
url http://link.springer.com/article/10.1186/s12885-019-5758-2
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